Androgen Receptor Genetic Variant Predicts COVID-19 Disease Severity: A Prospective Longitudinal Study of Hospitalized COVID-19 Male Patients.

Men infected with SARS-CoV-2 are more likely to be admitted to the intensive care unit (ICU) compared to women.1 Previously, we have reported that among hospitalized men with COVID-19, 79% presented with androgenetic alopecia (AA) compared to 31-53% that would be expected in a similar aged match population.2 AA is known to be mediated by variations in the androgen receptor (AR) gene.3 In addition, the only known promoter of the enzyme implicated in SARS-CoV-2 infectivity, TMPRSS2, is regulated by an androgen response element.4 The polyglutamine repeat (CAG repeat) located in the AR gene is associated with androgen sensitivity and AA.3 These observations led us to hypothesize that variations in the AR gene may predispose male COVID-19 patients to increased disease severity.